Substance Use Screening using Virtual Agents: Towards Automated Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Alcohol, tobacco and illicit drug use cause significant loss quality of life, and represent a large economic burden on society. Standardized questionnaires have been developed to enable healthcare providers to screen individuals for substance misuse problems that may require intervention. Although routine use of these screeners is promoted in many healthcare organizations, their administration can be irregular and lack follow through. In addition, patients may be reluctant to report substance use. We report on the development and validation of a Virtual Agent designed to automate the administration of a standard substance use screening instrument. We report on two validation studies in which a total of 57 patients at a US Veterans Administration medical center were screened by the virtual agent, comparing first to a research assistant administering the standard screening questionnaire, and second to a standard computerized text-based implementation of the questionnaire. Assessment correlations between the agent and human administration were all significant, ranging from rho=0.83 to 0.94, with more disclosure to the agent. Correlations were lower for Study 2 (0.56 - 0.88), with participants significantly more satisfied with the Agent compared to the standard tool.

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